Artikel
Tracheal intubation and postoperative complaints - results of an interview
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Veröffentlicht: | 22. September 2005 |
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Introduction: Patients undergoing general anaesthesia due to tracheal intubation often suffer from hoarseness, aphonia or dysphagia in the postoperative periode. Causative factors of these complaints can be multifactorial [1]. The main target of our study was to investigate the reasons and the incidence of these problems in a large group of patients.
Methods: 10013 patients over 17 years undergoing anesthesia (general anesthesie with tracheal intubation [n=7491], laryngeal mask airway [n=1010], facial mask [n=808], regional anesthesia [n=749]) were included into the study.
A postoperative interview was performed with all patients at least 24 after operation. There it has been asked for problems like hoarseness, aphonia or dysphagia. If ther werde problems, a further interview took place at the 3. p.o. day and if necessary at the 7. p.o. day. In patients with persisting complaints at the 7. p.o. day a phoniatric examination (including videostroboscopy) was recommended.
Results: We observed hoarseness following tracheal intubation in 12.7 %, aphonia in 1.3 % and dysphagia in 10.2 % of all cases. We noticed after application of a laryngeal mask airway hoarseness in 5.8 %, aphonia in 1.1 % and dysphagia in 9,7 % of all cases. In patients with facial masks or with regional anesthesia occasionally complaints also were observed.
0.5 % of all patients had complaints at the 7. p.o. day. In 3 cases (0.04%) a partial vocal fold palsy was observed. We have seen in one case (0.01 %) a hematoma of the vocal fold after arteria carotis TEA.
Discussion: The observed incidence of hoarseness and dysphagia was lower then in other trials described (30-90 %) [2,3].
The recently described [4] high incidence (1.4 %) of vocal fold palsy following tracheal intubation could not be reproduced in our investigation at all.
References: [1] Anaesthesia 54 (1999), 444-453, [2] M E J Anesth 16 (2001), 29-40, [3] Anaesthesia 47 (1992), 213-216, [4] Chirurg 71 (2000), 539-544